Bonnie's Blog

Autistic-Like Video

Some children with Sensory Processing Disorders present with symptoms that are characteristic of autism.  This is the story of one family whose child was labeled autistic at a very young age.  His parents were frustrated that the recommended behavioral approach (ABA) did not seem to be meeting his needs.  They  discovered that he has a Sensory Processing disorder and instituted therapy to address his sensory processing and incorporated a Floortime approach to working with him.  And that made all the difference.

Autistic-Like Preview

School-Based and Clinic-Based Therapy: What’s the Difference?

Is there a difference?  Would your child ever need both?

 

When therapy is recommended for a child, the physician may often recommend that the parents pursue therapy through the school system.  Most people have heard that children can receive speech and occupational therapy through the schools at no charge.  And they sometimes can, but it comes with a lot of caveats. 

 

For the most part, public schools deliver speech or occupational therapy under the orders of the Individuals with Disabilities Act – Part B.  To qualify for services, children must meet the Act’s definition of being disabled.  The Act states that school-based therapy must focus only on goals that are related to a child’s ability to benefit from education.  Therefore, school-based therapy puts emphasis on functional oral and written communication skills.  Challenges that affect a child’s ability to function normally at home or in the broader community may be excluded from therapy.  For instance, speech impediments may not fall under the Individuals with Disabilities Act because a stutter or trouble forming Rs would not necessarily interfere with learning at school and sensory processing disorders, even though they can clearly impact a child's ability to learn and function in the school environment are often not addressed directly.  In fact most schools do not have the equipment required to effective treat sensory processing disorders.

 

On the other hand, clinic-based therapy takes a more global outlook on the well-being of the child and the family.  At Emerge – A Child’s Place, therapists will often coordinate with teachers, school-therapists, and physicians.  The children who receive support at Emerge are not limited to those fitting the federal government’s definition of disabled.  Emerge focuses first on defining the underlying foundations of each child’s challenges.  Subsequent therapy focuses on those foundations with goals that encompass success at home, school, public, and later adult life. 

 

Specific Differences

·         School-based therapy typically ends when the child no longer requires therapeutic intervention to perform school tasks.  Therapy at Emerge ends when a child has reached maximum potential or when the family can continue the therapy maintenance independently. 

·         When choosing a clinic-based therapy program, families can look for specific training, equipment, techniques, or certifications among their therapy providers. 

·         School-based therapy must limit itself to goals that relate directly to benefiting from school education.  Emerge can address those issues, plus Emerge is free to directly address issues of sensory processing, articulation, picky-eating, coordination, self-care, etc. 

·         With Emerge, productive therapy can begin before grade school and give a child the best possible head start on his or her individual school career.

·         Frequency, parental support, and parental involvement are all vitally important to most pediatric occupational and speech therapy plans.  With Emerge, parents and doctors have more say in the frequency of treatment and the goals of therapy.  Emerge gets parents highly involved in therapy and teaches parents ways to help and support their child’s development.

Autism rates now 1 in 100

The CDC has issued new figures that places the incidence of autism at 1 child out of every 100.  This figure continues the alarming trend over the last 15-20 years of increasing incidence.  When I speak at conferences, invaribly someone will ask, but don't you think that figure just reflects better and more inclusive diagnosis.  While I think that accounts for a small portion of the change, as a professional that has worked in the field for more than 30 years, there is no doubt in my mind that increasing numbers of children are falling on the autism spectrum.  And for every child on the spectrum, we see 3-4 who are not, but who demonstrate signficant sensory and behavioral regulatory challenges.  This a profound change from the children I saw in the early years of my practice, who primarily presented with a coordination issue.

Gluten Free Lunch Box-Class at Durham Whole Foods

From the Whole Foods Calendar:

Thursday, September 3
The Gluten-Free Lunch Box: Free Workshop

6:00 - 7:00 pm FREE

Join us for a free workshop presented by Debbie Jongkind, RD, LDN who is a Gluten-free Health Coach for people with Celiac Disease and Gluten Intolerance. Debbie will guide you through the best ways to build a healthy and exciting lunch box for your youngster who is unable to enjoy gluten in his or her diet. And you'll take home a free goody bag of some of our favorite products as well! Space is limited, please sign up at the customer service desk or call 919.286.2290.

Therapy Equipment Resource

From time to time I receive mailings from small companies that offer therapy equipment, often which is less expensive than when offered through a large company.  Affordable Therapy Solutions is one of these companies offering weighted blankets and vests, swing and scooter boards. As always, check with your child's therapist about the suitability of any of these items.

Getting Ready for Back to School

Returning to school is often welcomed by parents, but represents a big change in the lives of many children, even more so when they are starting a new school or program.  Check out the article below for lots of good back to school tips.

8 strategies to ease back-to-school

Get Ready for School using Interactive Metronome

In the remaining weeks of summer there is just enough time to undertake undertake an Interactive Metronome® (IM) program for your child.

The March/April 2001 issue of the American Journal of Occupational Therapy identified five core areas of statistically significant improvements gained through the IM training program:

• Attention and Focus
• Motor Control and Coordination
• Language Processing
• Reading and Math Fluency
• Ability to Regulate Aggression / Impulsivity

We have had a number of families use the Interactive Metronome program to improve their child's attention and focus, motor coordination (esp. for sports, dance, etc.) and frustration tolerance.

The program can be done as a stand-alone intervention or as a supplement to therapy services (at Emerge or elsewhere).

While Emerge offers this program year-round, the summer is often the best time to do it, due to the program's intensity.  It is typically a 15 session program completed over the course of 5 weeks.  While it can sometimes be adapted for use with younger children, it is most commonly used with children aged 7 and above.  If you are interested in exploring Interactive Metronome as an option for your child, please give us a call @ 928-0204.

In the remaining weeks of summer there is just enough time to undertake undertake an Interactive Metronome® (IM) program for your child.

The March/April 2001 issue of the American Journal of Occupational Therapy identified five core areas of statistically significant improvements gained through the IM training program:

• Attention and Focus
• Motor Control and Coordination
• Language Processing
• Reading and Math Fluency
• Ability to Regulate Aggression / Impulsivity

We have had a number of families use the Interactive Metronome program to improve their child's attention and focus, motor coordination (esp. for sports, dance, etc.) and frustration tolerance.

The program can be done as a stand-alone intervention or as a supplement to therapy services (at Emerge or elsewhere).

While Emerge offers this program year-round, the summer is often the best time to do it, due to the program's intensity.  It is typically a 15 session program completed over the course of 5 weeks.  While it can sometimes be adapted for use with younger children, it is most commonly used with children aged 7 and above.  If you are interested in exploring Interactive Metronome as an option for your child, please give us a call @ 928-0204.

Summer Time and the Living is Easy

Summer offers numerous opportunities for you to support your child's progress in occupational and/or speech therapy.  (Vacations and travel can also be challenging - see earlier posts: Summer Travel).

WATER PLAY:  Enjoy water play with your child.  And while a trip to the beach or pool is great, lots of water play can happen in your own yard.  Set up a small pool, sprinkler, tub, etc.  Add water toys.  If your child is hesitant, start slowly with a small container of water. 

• Try foam soap for tactile input. 
• Water squirters to encourage finger strength (esp. small squeeze ones).  
• Encourage pouring, stirring. 
• Add shells or rocks to gather from the bottom.  Try picking them up with tongs or zoo sticks.  Talk about their shape and color.  Sort them into different categories.  Put them into an egg carton.
• Add large paint brushes and 'paint with water' on driveway or house.
• Look for local playgrounds that have a water feature (eg:  Forest Hills Park has an impressive sprinkler area and a faucet in the sand area - hint:  if you smash sand around the button it will stay)
• Add boats or foam trays.  Try other things - What floats and what doesn't. 
• Sponges are great for developing hand strength.

Fine Motor Skills in Preschoolers

The development of fine motor skills is an important foundation for future success in school.  In an article published in the American Family Physician, Dr. Hamilton makes two very interesting obsevations about the identification of motor skill deficits in young children.  One, is that a diagnosis of difficulties is often missed because many parents do not recognize it as a serious and modifiable problem.  And second, when parents do present concerns to their physicians, it is common for the physiciams to reassure the parents that their child will outgrow any clumsiness or coordination challenges.  Young children with persistant difficulties with fine motor skills display higher rates of educational, emotional and social problems in adolescence.

Occupational therapy can play an important role in helping young children develop the fine and visual motor skills that they need to meet the demands of school.  Early intervention typically results in a shorter period of therapy and reduces the impact on a child's self esteem.  At Emerge, intervention can begin long before kindergarten if a child is experiencing delays.  Therapy can signficantly improve a child's skills and provide parents with lots of ideas for promoting skill development at home.

By age 2: Scribbles; turns pages 1 at a time; feeds self with spoon and fork

By age 3:  Copies circle and cross; holds pencil with thumb and 1 or 2 fingers; cuts with scissors

By age 4:  Copies a square; cuts out simple shapes; skillful with eating utensils; mature pencil grip

By age 5:  Clear hand preference (often much earlier); draws a variety of recognizable pictures; copies a triangle, writes name, colors within the lines.

If you have a child entering kindergarten who has not mastered the 4 and 5 year old level skills, consider enrolling them in Emerge's Capable Kindergarten summer program. (Call 928-0204).

Supporting speech development with pictures

Photos and pictures provide great support for children as they develop their language skills, both receptive (understanding) and expressive (talking). 

1)  Put pictures of your child, family members, teachers, toys, activities, etc. into a child friendly photo album.  Use the photo album to look through with your child.

2)  Place pictures in magnetic photo holders and place the pictures on the refrigerator for easy access.

3)  Make small books about outings your child has been on, using pictures taken on the outing.  These books provide great support to help your child tell/show others about the outing.

4) Help your child make a placemat using stickers or small pictures of words in their vocabulary.  Cover the mat with clear contact paper.  These were made by 19 month old Jack with stickers representing words he knows.